Supported decision making is a framework that helps people with disability make their own decisions with support, rather than having decisions made for them by guardians or administrators. It respects autonomy, builds capacity, and empowers individuals to exercise choice and control in their lives.

This guide explains what supported decision making is, how it differs from guardianship, how NDIS funds decision-making supports, practical strategies for implementing supported decision making, and legal frameworks in Australia.

What is Supported Decision Making?

Supported decision making (SDM) is a process where:

  • You make your own decisions (you are the decision maker)
  • With support from people you trust
  • Support helps you understand options, consequences, and make informed choices
  • You retain legal capacity and decision-making rights

Core principles:

  1. Presumption of capacity - Everyone is assumed capable of making decisions unless proven otherwise
  2. Right to make decisions - Including the right to make decisions others disagree with
  3. Support to make decisions - Providing whatever support is needed to maximize capacity
  4. Least restrictive option - Only remove decision-making rights as absolute last resort

Supported decision making is NOT:

  • Someone making decisions for you
  • Being told what to do
  • Guardianship or administration
  • Removing your rights

Why Supported Decision Making Matters

Autonomy and dignity:

  • Respects your right to direct your own life
  • Preserves dignity and self-determination
  • Builds on strengths and capacity

Better outcomes:

  • Research shows supported decision making leads to:
    • Better quality of life
    • Higher satisfaction with decisions
    • Increased independence
    • Stronger relationships

Capacity building:

  • Learning to make decisions builds skills
  • Confidence grows with practice
  • Dependence on others decreases over time

Human rights:

  • United Nations Convention on Rights of Persons with Disabilities (CRPD) Article 12 emphasizes:
    • Equal recognition before the law
    • Right to exercise legal capacity
    • Access to support in decision making
    • Supported decision making over substitute decision making (guardianship)

Supported Decision Making vs Guardianship

AspectSupported Decision MakingGuardianship
Who decidesYou make decisionsGuardian makes decisions for you
Legal capacityYou retain legal rightsLegal rights removed
EmpowermentBuilds capacity and confidenceCreates dependence
FlexibilityTailored support as neededBroad removal of rights
ReversibilitySupport can change or stop anytimeRequires tribunal review to revoke
PhilosophyMaximizing autonomyProtecting from harm
FocusStrengths-basedDeficit-based
CRPD complianceComplies with Article 12Inconsistent with Article 12

When guardianship might be considered:

  • Only as absolute last resort
  • When all supported decision making options exhausted
  • When person consistently makes decisions causing serious harm AND
  • Cannot understand even with maximum support

Current trend: Movement away from guardianship toward supported decision making globally.

What Decisions Can Be Supported?

NDIS-related decisions:

  • Choosing NDIS goals
  • Selecting providers
  • Plan management decisions
  • Consent to supports
  • Complaints and appeals

Health and medical decisions:

  • Consent to medical treatment
  • Choosing doctors and specialists
  • Mental health treatment decisions
  • End-of-life care preferences

Financial decisions:

  • Banking and money management
  • Budgeting and spending
  • Contracts and agreements
  • Major purchases

Accommodation and living decisions:

  • Where to live
  • Who to live with
  • Daily routines and lifestyle
  • Moving house

Personal and social decisions:

  • Relationships and friendships
  • Sexual and reproductive rights
  • Social and recreational activities
  • Religious and cultural practices

Legal decisions:

  • Signing documents
  • Legal representation
  • Understanding rights and responsibilities

How NDIS Funds Supported Decision Making

NDIS recognizes supported decision making as essential to participant choice and control.

Capacity Building: Improved Daily Living

NDIS can fund:

1. Decision-making skills training

  • Workshops on how to make decisions
  • Understanding options and consequences
  • Weighing up pros and cons
  • Expressing preferences clearly

Cost: $193-$214/hour (capacity building rate)

2. Communication supports

  • Speech pathology to develop communication skills
  • Communication aids (AAC devices, picture boards)
  • Training in self-advocacy
  • Assistive technology for communication

Cost: Varies (therapy rates, equipment under capital supports)

3. Information in accessible formats

  • Easy Read documents
  • Visual supports and social stories
  • Simplified explanations
  • Translation services

Cost: May be funded under plan management or capacity building

Capacity Building: Improved Relationships

NDIS can fund:

1. Advocacy support

  • Independent advocates to support decision making
  • Representation in meetings (NDIS, health, legal)
  • Support to understand and exercise rights

Cost: $193-$214/hour

2. Support coordination

  • Help navigate complex NDIS decisions
  • Coordinate information from multiple sources
  • Break down complex decisions into manageable steps
  • Connect to community resources

Cost: $193-$214/hour

3. Peer support

  • Connect with other participants who’ve made similar decisions
  • Peer mentoring programs
  • Shared decision-making experiences

Cost: Group programs or individual peer support

Core Supports

NDIS can fund:

Support workers to assist with daily decisions:

  • Understanding daily choices
  • Communicating preferences
  • Problem-solving challenges
  • Practical assistance to enact decisions

Cost: $54-$103/hour (depending on time and complexity)

Who Can Be a Supporter?

Supporters can include:

Family and friends:

  • People you trust
  • Know you well
  • Respect your choices
  • Available when needed

Professionals:

  • Support coordinators
  • Advocates
  • Therapists (OT, speech pathology, psychology)
  • Social workers

Paid supports:

  • Support workers
  • Decision-making coaches
  • Peer supporters

Community members:

  • Faith or cultural leaders
  • Teachers or mentors
  • Community organization staff

Characteristics of good supporters:

  • Respect your autonomy - Recognize it’s your decision
  • Listen without judgment - Don’t impose their own views
  • Provide information - Help you understand options
  • Communicate clearly - Use accessible communication
  • Patient and available - Give time to process and decide
  • Trustworthy - Act in your best interest

Red flags:

  • Pressure you to make specific decision
  • Make decisions for you without consultation
  • Dismiss your preferences
  • Act in their own interest, not yours
  • Withhold information or limit options

Strategies for Effective Supported Decision Making

1. Accessible Information

Strategies:

  • Easy Read documents (simple language, pictures)
  • Visual supports (photos, diagrams, social stories)
  • Videos and demonstrations
  • Hands-on experiences (trials, visits)
  • Breaking information into small chunks
  • Repeat and review information

Example: Choosing NDIS providers:

  • Easy Read provider profiles
  • Visit providers and see services
  • Talk to current participants
  • Pictures of staff and facilities
  • Summary of key differences

2. Structured Decision-Making Process

Steps:

  1. Identify the decision - What are you deciding?
  2. Gather information - What do you need to know?
  3. Identify options - What are your choices?
  4. Explore consequences - What happens with each option?
  5. Identify preferences - What matters most to you?
  6. Make decision - Choose option
  7. Enact decision - Put it into action
  8. Review - How did it go? Adjust if needed

Use visual decision-making tools:

  • Decision trees
  • Pro/con lists
  • Decision boards with pictures
  • Timelines showing consequences

3. Communication Supports

For people with communication difficulties:

AAC (Augmentative and Alternative Communication):

  • Communication boards or books
  • Speech-generating devices
  • Apps (Proloquo2Go, TouchChat)
  • Sign language or gesture systems

Interpreters and facilitators:

  • AUSLAN interpreters
  • Cultural interpreters
  • Facilitated communication (with safeguards)

Yes/no systems:

  • Clear yes/no signals (head nods, thumbs up/down)
  • Eye-gaze systems
  • Switch systems

4. Time and Repetition

Allow adequate time:

  • Don’t rush decisions
  • Provide information multiple times
  • Give time to process and think
  • Circle back to check understanding

Break decisions into smaller steps:

  • Big decisions: Break into manageable sub-decisions
  • Make one part at a time
  • Build confidence with smaller decisions first

5. Person-Centered Planning

Focus on:

  • What’s important TO you (your values, preferences)
  • What’s important FOR you (health, safety, wellbeing)
  • Balancing both

Use person-centered tools:

  • PATH (Planning Alternative Tomorrows with Hope)
  • MAPS (Making Action Plans)
  • One-page profiles
  • Communication charts

6. Trial and Error

Learning through experience:

  • Try an option and see how it goes
  • Review and adjust
  • It’s okay to change decisions
  • Learn from mistakes (supported)

Example: Choosing between two day programs:

  • Trial each for 2 weeks
  • Reflect on experiences
  • Make decision based on trial
  • Can change later if not working

Supported Decision Making Agreements

What is an SDM agreement?

A document that:

  • Identifies your supporters
  • Specifies what decisions they help with
  • Clarifies their role (support, not decide)
  • Outlines how disagreements are resolved

Types of agreements:

Informal Agreements

Characteristics:

  • Not legally binding
  • Flexible and changeable
  • Between you and supporters
  • No official process

Example: Simple written statement: “I choose my sister Jane to help me make decisions about my NDIS plan and my friend Mark to help me with health decisions. They will provide information, discuss options with me, and help me communicate my decisions, but I will make the final decisions.”

Formal Agreements

Characteristics:

  • Documented and witnessed
  • May have legal recognition (depending on state)
  • More structured process
  • Clearer enforceability

Some states have legal frameworks:

  • South Australia: Advance Care Directives Act includes SDM
  • Victoria: Supported Decision-Making pilot programs
  • Other states: Evolving frameworks

Elements of formal SDM agreement:

  • Parties: You and your supporters
  • Decisions covered: NDIS, health, finances, etc.
  • Role of supporters: What they will do (provide info, discuss options, help communicate)
  • What supporters won’t do: Make decisions for you
  • Duration: Ongoing or time-limited
  • Review process: When and how to review
  • Dispute resolution: What happens if disagreement
  • Witnesses: Independent witnesses to agreement

NDIS Nominees vs Supported Decision Making

NDIS nominees are different from supported decision making:

Plan Nominee

Role:

  • Makes decisions about your NDIS plan on your behalf
  • Communicates with NDIA
  • Approves plan and changes

When appointed:

  • Participant cannot make plan decisions even with support
  • Often children (parent as nominee)
  • Adults with very limited capacity

Key point: Plan nominee makes decisions FOR you (substitute decision making), not WITH you (supported decision making).

Correspondence Nominee

Role:

  • Receives and manages NDIS correspondence on your behalf
  • Communicates with NDIA
  • You still make decisions

More aligned with supported decision making:

  • Can help you understand NDIS information
  • Support you to make decisions
  • Communicate your decisions to NDIA

Difference from plan nominee:

  • You make decisions
  • Correspondence nominee assists with communication

Transitioning from Nominee to Supported Decision Making

If you have a nominee but want to make your own decisions:

  1. Discuss with nominee and LAC
  2. Request nominee cancellation
  3. Put supported decision making in place
  4. NDIA must consider if you can make decisions with support before continuing nominee

NDIA’s role:

  • Presume capacity
  • Explore supported decision making
  • Only appoint or continue nominee if necessary

When Supported Decision Making Isn’t Working

Signs SDM may need adjustment:

  • You feel pressured or controlled
  • Supporters disagree and create conflict
  • You’re not understanding information even with support
  • Decisions consistently result in harm
  • Supporters are acting in their own interest

What to do:

1. Review and adjust:

  • Change supporters
  • Try different communication strategies
  • More time and support
  • Professional facilitation

2. Seek advocacy:

  • Independent advocate to review process
  • Mediation if conflict with supporters
  • Legal advice if rights being violated

3. Consider alternatives:

  • If SDM genuinely not working after exhausting all options
  • Guardianship tribunal may consider limited guardianship (specific decisions only)
  • Continue SDM for decisions where it works

Important: Difficulty with SDM is not automatic grounds for guardianship. Tribunals must explore all less restrictive options first.

Guardianship Legislation

Each state/territory has guardianship laws:

  • New South Wales: Guardianship Act 1987
  • Victoria: Guardianship and Administration Act 2019
  • Queensland: Guardianship and Administration Act 2000
  • South Australia: Guardianship and Administration Act 1993
  • Western Australia: Guardianship and Administration Act 1990
  • Tasmania: Guardianship and Administration Act 1995
  • Northern Territory: Adult Guardianship Act 2016
  • ACT: Guardianship and Management of Property Act 1991

Common principles across states:

  • Presumption of capacity
  • Right to make decisions with support
  • Least restrictive option
  • Supported decision making preferred over guardianship

Supported Decision Making Recognition

South Australia:

  • Advance Care Directives Act 2013 includes provision for SDM
  • Can formally appoint SDM supporters

Victoria:

  • Guardianship and Administration Act 2019 recognizes SDM
  • Supportive Attorney (similar to SDM) can be appointed

Other states:

  • Increasing recognition in case law
  • Tribunals required to consider SDM before appointing guardians
  • Evolving policy and practice frameworks

Frequently Asked Questions

Can I have both supported decision making and a nominee?

Yes, for different types of decisions. For example, you might have a correspondence nominee to help with NDIS communication but use supported decision making for health decisions. However, if you have a plan nominee (who makes NDIS decisions for you), that’s substitute decision making, not supported decision making for NDIS matters.

What if my supporters disagree with each other?

You can have a process for resolving disagreements in your SDM agreement. Options include: you make the final decision (even if supporters disagree), appoint a third person to help resolve conflict, or change supporters if conflict is ongoing. The key is that you remain the decision maker.

Yes. Courts and tribunals increasingly recognize supported decision making. You can have a support person with you in legal proceedings, use communication supports, and have information provided in accessible formats. Legal capacity to make decisions is presumed unless proven otherwise.

What if my family doesn’t support my decisions?

You have the right to make your own decisions, even if family disagrees. Supported decision making recognizes the right to make decisions others think are unwise, as long as you understand the decision. If family is trying to impose guardianship against your wishes, seek independent advocacy and legal support.

How do I prove I can make decisions with support?

Demonstrate:

  • You understand the decision (even if support is needed)
  • You can weigh options and consequences (with accessible information)
  • You can communicate a decision (using whatever communication method works for you)
  • You’re making the decision freely (not coerced)

Professional assessments from psychologists, occupational therapists, or speech pathologists can support this.

Can I change my supporters?

Yes, anytime. Supported decision making is flexible. If a supporter isn’t working out, you can ask someone else to support you instead.

Key Takeaways

Supported decision making empowers autonomy:

  • You make decisions with support
  • Retain legal capacity and rights
  • Build skills and confidence
  • Person-centered and flexible

Different from guardianship:

  • Guardianship removes rights (last resort)
  • SDM preserves rights and builds capacity
  • SDM is preferred and less restrictive

NDIS funds decision-making supports:

  • Capacity building (skills training, advocacy, communication)
  • Support coordination
  • Support workers to assist with daily decisions
  • Typical funding: $2,000-$15,000/year depending on needs

Good supported decision making involves:

  • Accessible information
  • Trusted supporters
  • Structured process
  • Adequate time
  • Communication supports
  • Person-centered approach

Legal frameworks evolving:

  • Guardianship laws require considering SDM first
  • Some states have formal SDM recognition
  • International human rights standards favor SDM

You have the right:

  • To make your own decisions
  • To support to make decisions
  • To change your mind
  • To make decisions others disagree with

Supported decision making is about respecting autonomy while providing whatever support is needed to exercise that autonomy. With the right supports, most people can make their own decisions across most or all areas of life, avoiding the need for guardianship and maintaining dignity, independence, and self-determination.